Provider Demographics
NPI:1568960276
Name:GRAY, LAYTON WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:LAYTON
Middle Name:WESLEY
Last Name:GRAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E GAY ST
Mailing Address - Street 2:STE C
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3107
Mailing Address - Country:US
Mailing Address - Phone:660-429-1900
Mailing Address - Fax:
Practice Address - Street 1:510 E GAY ST
Practice Address - Street 2:STE C
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3107
Practice Address - Country:US
Practice Address - Phone:660-429-1900
Practice Address - Fax:660-829-9051
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018001424111N00000X
VA0104557499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor